Minority Women Lag in Awareness of Heart Disease

Action Points

A study of awareness of CVD was conducted by the AHA in 2012 among U.S. women older than 25 and compared with prior surveys.

Between 1997 and 2012, the rate of awareness of CVD as the leading cause of death nearly doubled but a significant racial/ethnic minority gap persists.

More women today recognize heart disease as a major threat to life than over the past 15 years, but gaps in that awareness still exist among minorities, a special report from the American Heart Association (AHA) found.

In 1997, 30% of women surveyed said heart disease was the leading cause of death among women compared with 56% in 2012 (P<0.001), reported Lori Mosca, MD, chair of the AHA writing committee, and colleagues.

In 2012, black and Hispanic women showed an increased awareness of heart disease's importance (from 15% to 36% and 20% to 34%, respectively), but the current rate barely rises above the 1997 rate for white women (33%), researchers reported online in Circulation: Journal of the American Heart Association.

The 2012 survey was conducted by phone (n=1,205) and online (n=1,227) and included women over age 25. Researchers compared the 2012 results with data gathered from surveys conducted in 1997, 2000, 2003, 2006, and 2009.

Researchers found that awareness of heart disease as a major killer of women doubled or nearly doubled across the racial/ethnic groups, but the results of this study "suggest that future educational efforts should be targeted to racial and ethnic minorities who have lower rates of awareness and higher rates of CVD mortality and risk factors."

They also suggested that traditional outreach efforts from organizations like the AHA might need to be rethought in terms of getting the message to minorities.

Blacks, for example, were more likely to state the importance of church and God in their health. Black women also indicated a higher trust in their healthcare provider (87%) compared with white (78%) and Hispanic (72%) women.

More Hispanic women, on the other hand, indicated that their healthcare provider was not sensitive to their culture when making recommendations compared with whites and blacks (33% versus 24% and 23%, respectively).

Also of importance is how women perceived cancer then and now. In 1997, 35% of those surveyed overall said cancer was the leading cause of death in women. That rate fell to 24% in 2012, a significant difference. Although more women today than in 1997 labeled heart disease as deadlier than cancer, only the increase among white women was significant.

Mosca and colleagues found some interesting differences in demographic characteristics among the phone respondents (1,000 in 1997 and 1,205 in 2012).

Compared with 1997 data, respondents in 2012 were significantly more likely to be older (in groups 45-54, and 55-64), married or living with someone, and have a relatively high income ($75,000 or more).

Compared with 1997, women over 65 tended to be white, and Hispanic women were more likely to be in the youngest group.

Online respondents (1,227) compared with those surveyed by phone tended to be younger, separated or divorced, uninsured, inactive, and to report being 20 lbs. overweight.

In the online survey, women were asked the reasons they took preventive action in the past year. The most common reasons why respondents took preventive action were to improve health (64%), feel better (61%), and live longer (41%). Additionally, 28% wanted to avoid taking medication.

In the overall population, here are some differences between the two time points regarding warning signs and action:

More women now were aware of atypical signs of a heart attack than in 1997 (18% versus 10%)

Less women cited chest pain as a warning sign of heart attack in 2012 compared with 1997 (56% versus 67%)

More women would call 9-1-1 today than in 2009 -- when the question was first asked (65% versus 53%)

Nearly 80% of the online respondents said they maintained a healthy blood pressure as part of the heart-healthy lifestyle. Another 58% reduced the amount of salt in their diet and 57% paid attention to foods with omega-3 fatty acids.

Mosca and colleagues noted that about 0ne-fourth of respondents reported having depression, which could be a "potential barrier to adherence to guidelines for the prevention of CVD among women."

They said more data are needed to understand the gaps in knowledge among minority women and that future educational efforts around prevention and awareness need to comprise "culturally relevant components."

The investigators noted some limitations, including the results may not pertain to non-English-speaking women or those unwilling to take part in phone and online surveys.

In addition, chance could be the reason for some significant findings because researchers didn't adjust for multiple comparisons, and cell phone use could have introduced bias because these devices were not used in 1997.

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